- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,593.13 / $9,907.12 / $19,318.16
| Facility | | $7,593.13 | $9,907.12 | $19,318.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.25 / $663.45 / $2,304.75
| Facility | | $273.25 | $663.45 | $2,304.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.20 / $642.35 / $946.72
| Facility | | $429.20 | $642.35 | $946.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |